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General NPI Number Information
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NPI Number | 1164889085
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Entity Type | Organization
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Legal Business Name | OBGYN NORTH
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Dates
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Enumeration Date | 01/22/2016
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 12221 RENFERT WAY STE 330
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City | AUSTIN
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State | TX
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Zip | 78758-5374
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Country | US
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Telephone | 512-425-3825
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Fax |
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Provider Business Mailing Address
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Address Line | 1263 S AUSTIN AVE
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City | GEORGETOWN
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State | TX
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Zip | 78626-6714
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Country | US
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Telephone | 512-983-4857
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Fax |
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Authorized Official
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Title or Position | OBGYN, OWNER
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Name | DR. CHRISTINA SEBESTYEN
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Credential | MD
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Telephone | 512-425-3825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | AP130086
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License Number State | TX
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